Role of Nurse Practitioners in Meeting Increased Demand for Primary Care
Foundational Work: Issue
The United States keeps experiencing an ever increasing demand for primary care in the past few decades and expects the trend to keep on for the foreseeable future. The increase in demand for primary care is attributed to a number of enabling factors such as the adoption of the Affordable Care Act, (ACA) the expansion of insurance coverage and the increase in aging populations. With the adoption of the Affordable Care Act in the United States, Weinberg & Kallerman (2014) note that several millions of citizens gain access to primary medical care unlike the situation in the past, prompting the need to expand the healthcare supply systems. The process of increasing medical supply for primary care is however complex due to the limited supply of medical practitioners in the United States.
Weinberg & Kallerman (2014) argues that rapid increase in the number of healthcare practitioners in the primary care settings is difficult, prompting the need for maximum utilization of the available medical practitioners. With this argument, the researchers opine that roles of the available medical practitioners such as the nurse practitioners should undergo an expansion to help enhance the level of access to the much needed primary care to millions of patients. The increase in demand for primary care must be addressed with the provision of high quality and efficient healthcare services, which cannot be sufficiently provided by physicians due to their limited supply. The nurse practitioners have been around for several decades as observed by Weinberg & Kallerman (2014) and the expansion of their roles has helped cover for several physician roles due to the predominant limited supply of medical physicians in the US.
According to ACP (2009), the expansion of insurance care and the increase in aging population due to the high life expectancy rates of the US have led to a phenomenal increase in demand for primary care. The demand was additionally catalyzed by the adoption of the ACA that made primary care accessible to millions of ordinary Americans who were hitherto unable to affordable the services for primary care. ACP (2009) notes that the nurse practitioners are the most suited to help cater for the increased number of patients seeking primary care because their roles have undergone a tremendous expansion for the past twenty years through the adoption to various acts permitting them to perform several physician roles.
The most notable roles assigned to nurse practitioners under the expanded roles scheme is the prescription of drugs, third-party reimbursement, admission of patients and disease diagnosis. The roles of both nursing practitioners and those of the physicians are thus similar, prompting the need to have the nurses play an enhanced role in mitigating the increased demand for primary care. The number of nurse practitioners is higher when compared to that of the physicians registered in the US, prompting the need to efficiently utilize them to help provide quality care for the increased number of patients seeking primary care. However, to help increase the roles of the nurse practitioners in a bid to meet the increased demand for primary care, most states need to enact legislations allowing nurse practitioners to undertake various roles reserved for the physicians in their jurisdictions.
Foundational Work: Stakeholders
Access to primary care is of great importance to the elderly and persons with less complex ailments. The increase in demand for primary care affects the healthcare system prompting the need to develop mechanisms to help provide quality care to the high number of persons seeking the primary care services. The most affected persons by the increased demand for the primary care are the elderly, low-income earners who found it difficult to access the primary care services before the adoption of the Affordable Care Act, the nurse practitioners and the physicians.
Berenson et al. (2012) note that the poor in the United States have experienced several inequities in their access to vital services for several decades prompting the need to have their living standards and welfare alleviated by the US government. According to the researchers, the adult low-income earners in the United States face serious inequalities when it comes to their level of access to medical services and medical homes because most of them are uninsured. The cost of medication becomes unaffordable to this group of people making it difficult to have them access high quality and decent medical care especially in primary care settings. Berenson et al. (2012) argue medical insurance to the poor helps them access better quality healthcare services though the level of care still doesn’t match that of the insured high income earners who subscribe for more sophisticated care services.
According to Berenson et al. (2012), the poor in the United States faced cost challenges when trying to access medical care in primary healthcare settings and could most of the time fail to access such services due to financial handicaps. The adoption of programs enhancing access to primary care is anchored on the low-income earners who are the main stakeholders affected by the programs and who comprise the highest group of people demanding for primary care. The surge in primary care demand is actually driven by the millions of the poor Americans who for the first time freely accessed primary care services with the aid of the Affordable Care Act and the expansion of various insurance services to help ensure they easily access the services without cost constrains.
The ACA and expansion of healthcare insurance services to the low income earners has helped mitigate the cost and prevalence of ailments among the poor since they now easily access screening services to help them acquire timely diagnoses for any ailments they may be suffering from (Trivedi et al., 2008). The poor in the US for several decades faced challenges of accessing medical homes and always suffered because of their inability to raise sufficient funds to care for their medical needs. The level of inequality in medical access was very wide between the wealthy and the poor and through the adoption to the ACA, the gap is considerably closed and this helps the poor enjoy more productive years due to good health. The increase in demand for the primary care catapulted by the establishment of programs sensitive to the healthcare needs of the poor brings to the fore another group of stakeholders which is the nurse practitioners.
Berenson et al. (2012) notes that the poor enjoy more satisfactory and high quality services under the affordable insurance coverage, which helps enjoy elongated life expectancy years leading to an increase in the number of elderly people seeking primary care services. It is therefore important to note that inasmuch as the regularization of medical access helps the poor access direct medical services in primary settings, it sets pace for increased demand in future demand for primary care services among the elderly. This happens through the increase in life expectancy levels among the poor resulting from increased access to high quality care.
Iglehart (2014) notes that the services of nurse practitioners have continued growing in importance for the past several decades in the United States and beyond more especially in primary care settings. The increased demand for the nurse practitioners is credited to the inability of the government to produce sufficient numbers of trained medical physicians to help provided high quality care to patients in need of primary care services. NGA (2012) observes that nurse practitioners provide high quality services to patients in primary care settings based of the patient outcome responses provided by patients seeking primary care services.
The nurse practitioners form a strong stakeholder group that helps ensure effective management of the increased demand for primary care. The nurse practitioners undertake expanded roles, similar to those executed by physicians to help ensure the physician scarcity never affects negatively the increased demand for primary care. The roles mostly undertaken by the nurse practitioners include the processing of third party re-imbursements, patient admissions, diagnosis and medical practitioners. The number of expended roles however varies from state to state depending on the adopted legislations with regard to the roles of nurse practitioners in primary care settings.
Foundational Work: Project Conceptualization
Project Implementation: Nurse’s Role and Responsibility
The implementation of this study project required an inter-professional team to help ensure representation of all stakeholders. The project team was comprised of nurse practitioners, physicians and patients in primary care settings supported by the Affordable Care Act provisions, expanded insurance services and those their just because of their advanced age. As the nurse leader mandated with the role of ensuring project success, it was my responsibility to ensure that the project met its objectives and concluded successfully. It was my responsibility to ensure all the data collection instruments were adequately provided, which included open-ended questionnaires and structured interviews. In addition to that, I had to ensure that the data collection process went on schedule across all states as was stipulated in the research proposal document.
My role in the research team was complex as I had to ensure proper co-ordination of all respondents across the eight study states in addition to compiling and analyzing all the necessary data. The main issue was to ascertain the role of nurse practitioners in helping meet the increased demand for primary care. It was my responsibility to ensure that this main objective was met and as such, I had to evaluate the roles of physicians and those of the nurse practitioners. It was equally my obligation to ensure the feedback from the patients comprising of those boosted by the adoption of the affordable care programs designed to enhance their access to primary care got captured. I had to ensure the roles of both nurse practitioners and physicians were analyzed and weighed in the lens of their suitability in helping mitigate the surging demand for primary care. Of importance was the observation of the number of available physicians and nurses in addition to the roles they perform to help decide whether the nurses had an integral role in meeting the increased demand for primary care.
References
- N. Trivedi, W. Rakowski, and J. Z. Ayanian. “Effect of Cost Sharing on Screening Mammography in Medicare Health Plans,” New England Journal of Medicine, Jan. 24, 2008 358(4):375–83.
